USING PHARMACIST CLINICAL INTERVENTION DATA FOR QUALITY IMPROVEMENT OF MEDICATION USE AND PHYSICIAN ASSESSMENT

Background: Patient-specific intervention data are often used for drug usage evaluation (DUE), but their use in physician assessment is less often discussed. In response to the quality assurance department's re quest, the pharmacy department at the Medical College of Georgia (Augu sta) developed a database and a reporting system that supports quality assessment of the medical staff, identifies housestaff education need s, and directs efforts for improvement in medication use. The reportin g system: In 1998 the comprehensive, concurrent screening of drug ther apy by pharmacists formed the foundation of the hospital's DUE program . Each month information from the pharmacy database is sorted with use of a spreadsheet software program to generate medical department-leve l reports and for use in physician reappointment. Identified performan ce deficiencies can be used to educate individual prescribers and to d evelop educational programs for the department or specialty areas. Fee dback from the medical staff assessment is useful for pharmacist educa tion, such as identifying newly reported indications and dosage regime ns. Results: During the first six months after all pharmacists began p articipating in the reporting program, a mean of 224 interventions wer e recorded monthly. For the period January through June 1994, 400-550 interventions were recorded monthly. System improvements in medication during the first year of implementation included hospitalwide guideli nes for parenteral potassium and phosphate dosing and administration a nd a renewed focus on patient allergies. Conclusion: Emphasis for use of intervention data has shifted from identifying ''problem'' persons to improving performance by identifying topics for corrective educatio n and redesigning systems to promote positive patient outcomes.